American Economic Journal:
Applied Economics
ISSN 1945-7782 (Print) | ISSN 1945-7790 (Online)
Health Care Spending and Utilization in Public and Private Medicare
American Economic Journal: Applied Economics
vol. 11,
no. 2, April 2019
(pp. 302–32)
Abstract
We compare health care spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their health care spending. Adjusting for enrollee mix, health care spending per enrollee in MA is 9 to 30 percent lower than in Traditional Medicare (TM), depending on the way we define "comparable" enrollees. Spending differences primarily reflect differences in health care utilization, with similar reductions for "high-value" and "low-value" care, rather than health care prices. We present evidence consistent with MA plans encouraging substitution to less expensive care and engaging in utilization management.Citation
Curto, Vilsa, Liran Einav, Amy Finkelstein, Jonathan Levin, and Jay Bhattacharya. 2019. "Health Care Spending and Utilization in Public and Private Medicare." American Economic Journal: Applied Economics 11 (2): 302–32. DOI: 10.1257/app.20170295Additional Materials
JEL Classification
- G22 Insurance; Insurance Companies; Actuarial Studies
- H44 Publicly Provided Goods: Mixed Markets
- H51 National Government Expenditures and Health
- I11 Analysis of Health Care Markets
- I13 Health Insurance, Public and Private